Worldwide Diagnostic Reference Levels for Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging

This study sought to establish worldwide and regional diagnostic reference levels (DRLs) achievable administered activities (AAAs) for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Reference serve as radiation dose benchmarks compare individual laboratories against aggregated data, helping identify sites in greatest need of reduction interventions. DRLs SPECT MPI have previously been derived from national or registries. To date there no multiregional reports a single standardized dataset. Data were submitted voluntarily the INCAPS (International Atomic Energy Agency Nuclear Cardiology Protocols Study), cross-sectional, multinational registry protocols. A total 7,103 studies included. AAAs calculated by protocol each world region data. The rest-stress stress-rest employing technetium Tc 99m–labeled radiopharmaceuticals 11.2 mCi (first dose) 32.0 (second 1-day protocols, 23.0 24.0 multiday Corresponding 10.1 28.0 17.8 18.7 For stress-only 99m studies, DRL AAA 18.0 12.5 mCi, respectively. Stress-first was used 26% 92% except North America where it just 7% cases. Significant differences observed between regions. major one largest international registries clinical studies. Regional may be useful establishing revising guidelines simply comparing laboratory protocols trends. Organizations should continue focus on reporting methods improve validity comparability DRLs.